Individual provider Active NPI

Tullia Valentina Johnston, DO

  • Student in an Organized Health Care Education/Training Program
  • Portsmouth, VA
National Provider Identifier
1912700469
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3640 High St Ste 3B
Portsmouth, VA 23707-3213
Phone
(757) 397-6344
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3640 High St Ste 3B
Portsmouth, VA 23707-3213

Mailing address

825 Fairfax Ave # 118
Norfolk, VA 23507-1914

Other practice location 1

825 Fairfax Ave # 118
Norfolk, VA 23507-1914
Phone (757) 446-5955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250926004041 VA Order and Referring Only - Family PracticePractitioner - Family Practice 4486159688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Podiatry, Inc PastSince Apr 6, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1912700469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE # 118",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 HIGH ST STE 3B",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073213",
            "telephone_number": "757-397-6344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Fairfax Ave # 118",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071914",
            "country_code": "US",
            "telephone_number": "757-446-5955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "TULLIA",
        "middle_name": "VALENTINA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.